Stages of Binge Eating Disorder

Newly Diagnosed

Learn more about this condition, including possible causes, treatments and how to get help.

When you hear the words “eating disorder,” you probably think of anorexia or bulimia.

You may be surprised to learn that the most common eating disorder is neither of these – it’s binge eating disorder (BED).

Many people don’t realize that a person can have an eating disorder and look just fine.

“People didn’t believe anything was wrong with me,” says Rachel Quetti, a college student in Massachusetts who suffered with binge eating disorder for almost two years.

“I looked healthy, but I was a mess,” Quetti says. “I’d have out-of-control episodes where I was stuffing myself with food from the vending machine until I felt sick. I wasn’t hungry, but I couldn’t stop. I stopped seeing friends. I was obsessed with food and eating.”

As many as 5% of people in the United States suffer from binge eating disorder – about 60% women and 40% men, according to the National Eating Disorders Association (NEDA). But it was only last year that the condition was recognized as a true eating disorder by the American Psychiatric Association in its Diagnostic and Statistical Manual of Mental Disorders (DSM-5).

“Binge eating disorder went too long without being recognized, but more than 1,000 research papers have established its validity and its prevalence,” says Russell Marx, M.D., chief science officer for NEDA and director of the adolescent program at University of California, San Diego Eating Disorders Center for Treatment and Research.

Having the condition doesn’t just mean you stuff yourself occasionally.

If these episodes occur at least once weekly for three months, you might be diagnosed with binge eating disorder, he says.

A sense of being out of control. “People with BED feel as though they can’t stop binging, even though they aren’t hungry,” Dr. Marx says.

Additional clues that you may have binge eating disorder include eating rapidly, eating alone or secretly and feeling disgusted or depressed afterward.

Binge eating disorder doesn’t include purging or over-exercising, symptoms of anorexia or bulimia. That’s why many (but not all) BED sufferers are overweight.

“Many people [incorrectly] think that having an eating disorder automatically means being anorexic or unnaturally thin. But people with larger bodies may also suffer from an eating disorder,” says Chevese Turner, CEO and founder of the Binge Eating Disorder Association (BEDA) in Severna Park, Md.

In fact, as many as 20% of people who are obese may have binge eating disorder, according to the National Alliance on Mental Illness, in Arlington, Va.

Risk factors for the disorder include:

Family history of BED. Researchers believe inherited genes make some people more susceptible to binge eating disorder. People who had a close family member with BED were more than twice as likely as others to have the disorder themselves, according to a 2006 study published in Archives of General Psychiatry.

History of psychiatric disorders. “Many people with binge eating disorder also have bipolar disorder, depression, anxiety and, to a lesser degree, substance use disorder [such as alcohol or drug dependence],” Dr. Marx says.

Compulsive dieting. Nearly all binge eaters have a history of dieting, Dr. Marx says. They sometimes continually cycle through diets in an attempt to stave off binges and lose excess weight.

Body dissatisfaction. Women and adolescents unhappy with their bodies are more likely to binge. Among obese women seeking treatment in weight-control programs, those who were less satisfied with their shape had higher binge-eating scores, regardless of their weight, according to a 2012 British study published in Obesity Research. And those whose body dissatisfaction decreased the most during treatment had the greatest improvement in binge eating.

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